2012, 05-03 Permit App: BLD-2012-0553 Plumbing FixturessO1� _ _ �\
.00iValley
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallev.org.com
Plumbing Permit Application
Mail or Fax To: r
Norm's Excavating, Inc. 7 L ° N
PO Box 574
Veradale, WA 99037
Fax: 892-0432
Wd8l:Ol 7107, '8 App ;Wll pani)q
61-D-7 i2-0,5 3
PERMIT NUMBER
PERMIT FEE: 4 ®,p
❑ Commercial ® Residential
SITE ADDRESS: _4412 N Mayhew
Biding owner
'
Name: Price
Phone: 220-1095
Fax:
Address: SAME
City:
Stade:
Zip:
Contractor
Name: Norm's Excavating, Inc
Phone: 509/928-0580
Fax: 509/892-0432
Address: PO Box 574
City : Veradale State:
WA
Zip: 99037
License No: NORMSEI972BM
City Business License No:
Contact
Name: Sheila Gibbons
Phone: 928-0580
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET. BIDETS
1
X
$6.00
6.00
2
URINALS
X
$6.00
3
TUBS
X
$6.00
4
SHOWERS (PER TRAP)
BATH. STALL, ON-SITE BUILT
1
X
$6.00
6.00
5
SINKS
LAVS/BASINS. BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, F000, PREP/CULINARY MEAT
1
X
$6.00
6.00
6
DISHWASHER
X
$6.00
7
CLOTHES WASHER
X
86.00
8
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER
X
$6.00
s
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
86.00
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
13
FOUNTAINS. DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION. ALTERATION, REPAIR,
REVERSALS
1
X
$6.00
6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
x
$6.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER. HOSE BIB.
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$6.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R_P.B.P.D. FOR: VATS. TANKS, BOILERS
X
$6.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE
INTERCEPTOR
X
815.00
METI40D OF PAYMENT:
❑ CASH ❑ CHECK
Card# See Cover Sheet
AUTHORIZED SIGNATURE:
® VISA 0 MASTERCARD
EXPIRES:
4171 ,'�%/lam / _
SUBTOTAL
24.00
P�2OCESSING FEE
37.00
TOTAL PERMIT FEE DUE:
61.00
REVISED 8/26105